The Category: Potpourri

I've fallen behind on the blog writing for a couple of weeks. I've taken on a slightly different work schedule which has left me kind of wiped out. August has been surprisingly busy, though. Anyway, here are some of the totally random things that have broken through my foggy mind lately....

1. When someone is discharged from any sort of health care facility they usually have a bunch of discharge instructions and crap thrown at them. In fact, the more elderly the person, the greater the volume of overwhelming crap. One of the things people invariably get is a "medication list." They bring it to the pharmacy, thinking it's a prescription. It's not. By the way, I maintain that anybody who wants to get involved with MTM should be looking at hospital/long term care discharges before anything else. Most medical errors occur during 'transitions' in care, and maybe an added bonus would be simplifying things for everyone involved. Figure out what the person has been taking, what they need and don't need, what they need to continue or discontinue, and generate prescriptions that are pharmacy-ready for the doc to sign. What doctor/on-call person/first-year resident wouldn't like that?

2. A woman brought in a single pill (yes, just one tablet) and said she wanted a refill on 'that.' Quickly relieved of the notion that she might know the name of it, or what it was for, I finally got to use my Epocrates Pill ID function on my smartphone. Man, that is slick!

3. Thank you, someone at Big University Clinic, for giving my customer a prescription for Percocet. The signature is illegible, the 'printed name' is illegible, the DEA number I might be able to guess at (but all possible guesses match no one in my system), and of course there's no NPI. The customer is bellowing at me because it's taking so long. The recording on the other end of the phone number on the prescription says you are 'unavailable to take my call.' This makes me very, very grumpy.

4. It's back to school time and the ADD prescriptions are flowing like water after a hurricane. And naturally, the wholesaler's running out of Adderall. Again.

5. I can't get over the number of highly educated and otherwise very competent people who can't spell. My current pet peeve is two words: "LOOSE" is the opposite of "tight" , while "LOSE" is the opposite of "win." So for instance, when I read that someone is about to 'loose' their insurance, I wonder why it was so tight in the first place. It's just a thing with me....

Rolling the Dice Every Day

This was a weird, long week. Things are slower, as they often are in August, but the situations that do come up seem to be just ---- strange. It was a full moon, however, so that explains a lot.

I actually got to feeling good this week, because I had TWO people tell me "I feel better after talking to you." Both were phone conversations followed up by a face-to-face meeting at the pharmacy later in the day. They were both upset for different reasons, but because we were not too busy I was able to sit down, stay on the phone, let them vent a little and then offer some sympathy and understanding as best I could. One person came in later and shook my hand, and the other one actually apologized for her loss of temper.

What bothers me, though, is that more often than not I cannot do this. Most of the time I'm overwhelmed with work and have many people waiting on me. It is really hard to spend that much time on the phone with someone and think clearly about the best way to handle the situation. There are many times when I've had to be somewhat abrupt and in a hurry to end the conversation because I just can't let it go on and on. I don't feel good about it, but it simply isn't humanly possible when all people care about is how long their prescription is going to take.

I don't like confrontations with upset people, and I have never received any training on how to deal with it -- it's mostly on-the-job training and observing how other people handle it. If someone is being rude and snippy to me I find it VERY difficult to keep a pleasant tone, even though that's what we are supposed to do. And believe me, there are plenty of people who really piss me off with their lack of responsibility, entitlement issues, and lack of respect for the service I am attempting to provide. That's why I found these two situations ultimately so rewarding. I know it was because I was able to take the time and talk to them for awhile. I'm also totally aware that it's a complete crapshoot as to how often I'll be able to do that.

Perspective

In spite of all the pissing and moaning we may do on our blogs, I for one never let a day go by without realizing how fortunate I am. Seeing the pictures coming out of the refugee camps in Kenya--- where literally millions are at risk for starvation -- makes me unsettled, scared and heartbroken. I can't help but think about the accident of birth that let me grow up in a land of plenty while others face doom from their first day of life. Why is it them and not me?

In the pharmacy where I fill in some shifts, there are a lot of customers who are African immigrants. We treat them with the same courtesies that everyone else gets. As I've mentioned before, in spite of the lack of English-speaking skills they tend to learn one phrase quickly, which is "How long?" Just yesterday a man approached the counter and protested that he had been waiting 'TWENTY MINUTES!!'

One of our cashiers is also of African origin. He's been in the USA for quite awhile and shakes his head at this sort of thing. He has family back in Africa and related to us what he saw happen when someone in the village gets seriously ill. If that person is really lucky, four people will be available to carry him to the next village to find some medical help. That's the BEST-case scenario.

So, all of a sudden that 20-minute wait doesn't seem so bad. And that's true no matter what country you came from.

Perspective, people.